Preventive Neurologist Shares Tips to Help Reduce Alzheimer’s Risk

When Dr. Kellyann Niotis first started studying neurology, she remembers learning about how to manage diseases like Alzheimer’s and dementia.

It was the lack of information on how to prevent them that she couldn’t wrap her mind around.

“My family has been touched by neurodegenerative disease and I have seen countless patients go through these diseases,” Niotis, a preventive neurologist and an assistant professor of neurology at Weill Cornell Medicine, told Business Insider. “What hits me the most is that the disease doesn’t just impact that person; it really impacts everybody.”

Niotis was inspired to specialize in preventive neurology when she found existing lifestyle advice lacking. “It was heartbreaking for me to hear, time and time again, doctors saying there’s nothing you can do or just give generic health advice that had no real concreteness or tie to neurology.”

While diet and exercise are linked to better brain health, Niotis wanted to get more granular. Which foods were the best, and why? Are some exercises better than others?

Niotis, who’s spent the last decade in the neurology field, shared a few of her own habits to reduce her Alzheimer’s risk, based on what she learned from her research.

Her diet staples are berries, fatty fish, and lots of water

Niotis said that most Americans don’t drink enough water — or realize how important hydration is for brain health.

“Our brains are mainly made up of both fat and water,” she said. “Even mild levels of dehydration can cause issues with concentration, attention, and the sensation of brain fog.”

Niotis always carries a large water bottle with markings on it so she can visually track how much water she’s had in a day.

When it comes to her diet, she only has a few hard guidelines for herself. “I eat berries every single day,” she said. “That is one of my live-by rules.” Berries are rich in polyphenols and other antioxidants that may help reduce oxidative stress and inflammation. Some observational studies have linked higher berry consumption with slower cognitive decline.

She also tries to eat fatty fish, such as salmon, sardines, mackerel, and anchovies — twice a week. “They’re the ones that usually are more stinky, so are less appetizing for a lot of people,” Niotis said. “But I really do try to do that.”

Fatty fish have higher levels of omega-3 fatty acids such as DHA and EPA, which help maintain healthy brain cell membranes and can also reduce inflammation.

Serious strength training seems to lower the risk of neurodegeneration

Niotis generally exercises four to five times a week, opting for a mix of strength training and cardio.

The former, she said, is especially important for brain health. Women, who tend to lose more muscle mass than men on average, are especially at risk of developing sarcopenia, age-related muscle mass loss that is linked to neuromuscular degeneration.

Skeletal muscle and the brain communicate through metabolic and signaling pathways. Lower muscle mass has been associated with smaller hippocampal volume and poorer cognitive outcomes in some studies.

Sometimes, the risks can be more direct: low muscle mass puts you at greater risk for falls and subsequent brain injuries when you’re older, Niotis said. It inspired her to add more strength training into her fitness routine.

Still, she said it took her time to get used to lifting heavier. “When I first started, I did very easy circuit machines at the gym because I really didn’t know very much about putting on muscle mass, and I was very worried I was going to hurt myself,” she said. She would do higher reps of lower weights, which she now knows aren’t as helpful for building or maintaining muscle.

Instead, she aims for six to 10 reps of a heavier weight for three or four sets to progressively overload and more effectively boost her muscle mass.

Adding variety to her routine stimulates her brain

In general, Niotis tries to sprinkle in variety where she can.

“The brain loves novelty,” she said. “Anytime you’re challenging your brain to do different things is a benefit.”

One easy way she does this is by switching out her cardio exercises, from running to rowing to cycling. Whichever one she does, she opts for short bursts of intensity where she reaches a heart rate target of about 85% (or a zone 4 heart rate) for up to two minutes before recovering.

Besides the fact that good heart health helps support better blood flow to the brain, she said getting out of her comfort zone may help increase brain reserve. “After exercise, I feel my brain is very sharp,” she said.

She tries to replicate that sharpness in other parts of her life, too. She said interacting with a lot of different people, whether at work or socially, also adds novelty.

“Anytime you’re talking to someone, you’re exposed to new thoughts, new ideas, new language,” she said. ” That in itself offers connectedness, which also can help the brain.”